VPI/A non-cleft VP insufficiency ablative palatal lesions? (1) maxillectomies, partial or total, that creat unwanted coupling between nasal and oral cavities in much the same way as a cleft does?
(2) penetrating wounds to orofacial structures

VPI/A non-cleft VP mislearning:
selective nasal emission on one or some of the HPCs in the absence of any significant hypernasality, and where other HPCs are produced with adequate oral pressures and oral air flow?

PSNE-phoneme specific nasal emission

VPI/A non-cleft VP mislearning?
persisting nasal emission in cleft palate youngsters who have their palates repaired and appear to have adequate VP closure capability but who continue to use old/early learned patterns of nasal air emission.

Not a speech problem and not a surgical problem?

with adequate closure ability

Persisting post-op nasal emission

VPI/A non-cleft VP mislearning:
VPI caused by maladaptive gestures?

Compensatory misarticulations

Post-surgical insufficiency:
Surgical closure of the cleft palate does not guarantee adequate function. 10-20% of children will require additional (secondary) surgery beyond the initial repair?

Post-palatal closure

Post-surgical insufficiency:
too aggressive an adenoidectomy (introgenic basis) or adenoidectomy unmasks a pre-existing insufficiency such as SMCP or OSMCP?

Post-adenoidectomy

Post-surgical insufficiency:
or other form of secondary surgery; like initial palatoplasties, secondary surgeries are not always successful?

post-pharyngeal flap, post sphincter pharyngoplasty

Post-surgical insufficiency:
while fistulas are not sources of VP insufficiency they may contribute a (second) source of unwanted oronasal coupling, and therefore nasal air escape and hypernasal resonance?